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What is Sleep Drunkenness?

It takes the human brain a few minutes to fully wake up in the morning due to something called sleep inertia. But imagine what would happen if that groggy, confused state persisted for a couple of hours—even after your second cup of coffee.

In those who experience frequent episodes of sleep drunkenness, this is nothing new. And the worst part is that they often have no recollection of what happens during their episode. (In other words, while you can apologize to your spouse about what you said pre-coffee, a victim of sleep drunkenness won’t remember saying something unsavory to begin with.)

Let’s dig deeper.

Definition & Symptoms

Sleep drunkenness (also called “confusional arousal”) is a type of parasomnia that affects people who are waking up from deep sleep. This parasomnia is characterized by a marked sense of confusion, fear, or unawareness of one’s surroundings immediately after waking up.

During an episode of sleep drunkenness, one may appear dazed, act or speak out of character, or even act out in violence. The duration of symptoms varies from a few minutes to several hours, and the person will usually have no memory of what happened once the episode is over.

While it takes everyone a few minutes to wake up in the morning, the normal sleep inertia process that brings us from slumber to wakefulness is disrupted in those experiencing sleep drunkenness. Rather than transitioning normally into wakefulness, they will remain in a state of relative stupor until the episode passes.

Causes

There is no single cause of sleep drunkenness, though sleep scientists believe that it is normally a symptom of a larger problem rather than a disorder in and of itself. There are several potential causes of sleep drunkenness, and the phenomenon is more common in children than in adults.

— Sleep Disorders

According to a 2014 entry by LA Times, over 70% of sleep drunkenness occurrences take place alongside another sleep disorder. This means that anyone experiencing insomnia, sleepwalking, sleep apnea, restless leg syndrome, or another sleep disorder are far more likely than the rest of the population to experience sleep drunkenness at some point.

— Mental Disorders

The aforementioned report also mentions that mental disorders are present in a considerable chunk of sleep drunkenness cases. In particular, experts have found that those with depression, panic disorder, bipolar disorder, or PTSD are likely to experience sleep drunkenness.

While this may be due in part to the disorder itself, some studies have shown that certain medications linked to these disorders (called psychotropic medications) may induce or worsen symptoms of sleep drunkenness.

— Stress or Anxiety

Because episodes of sleep drunkenness tend to correlate with disorders that disrupt sleep, it comes as no surprise that experiencing stress or anxiety can also result in sleep drunkenness. During times of stress, the human body produces more stress hormones (namely, cortisol and adrenaline); these hormones keep the mind and body extra alert, which can result in poor sleep—especially if the stress or anxiety is triggered before bedtime or is chronic.

— Consumption of Caffeine or Alcohol

Caffeine is a natural stimulant that helps the brain become more alert and stimulates the nervous system. Drinking too much coffee during the day (or any amount close to bedtime) can cause difficulty sleeping, thus creating the perfect conditions for an episode of sleep drunkenness to occur.

Alcohol consumption can also have negative effects on sleep length and quality. While alcohol is a depressant rather than a stimulant, it causes disruptions in sleep—especially later on in the cycle, when we normally experience REM sleep.

This means that those who consume alcohol close to bedtime tend to receive more slow-wave sleep and less REM sleep; this results in receiving fewer of the benefits from REM sleep, such as the storing of long-term memories.

Both caffeine and alcohol consumption should be limited or avoided near bedtime, as their negative effects on sleep can potentially result in sleep drunkenness the following morning.

— Irregular Sleep or Work Schedule

Another risk factor for sleep drunkenness is having an irregular sleep or work schedule. Those who are particularly susceptible to episodes of sleep drunkenness include:

  • Those who work irregular shifts
  • Those who put in long hours at work
  • Those who are on-call

This is because of the human circadian rhythm (also called the “sleep-wake cycle”), which regulates our sleep and wake patterns. The circadian rhythm controls the release of certain hormones into our bloodstream, causing larger amounts of cortisol and adrenaline to be released early in the day and less at night.

When we go against the body’s natural sleep-wake cycle—such as by working night shift, taking frequent naps during the day, or simply not getting enough sleep each night—this predisposes us to a range of negative symptoms: irritability, weakening of the immune system, memory issues…and yes, sleep drunkenness.

Diagnosis & Treatment

It’s important to note that someone who experiences sleep drunkenness may not be aware of it themselves. In most cases, a person only becomes aware of their sleep drunkenness when a loved one brings it up.

If you suspect you may experience sleep drunkenness—especially on a regular basis—it would be wise to get checked out by a doctor. In order to properly diagnose you, the doctor will probably screen for other sleep or mental disorders; treating that will likely help your sleep drunkenness problem. You might need to undergo a sleep test to get the best diagnosis.

The most effective treatment may simply be to employ better sleep hygiene habits. These include, but are not limited to:

  • Limiting caffeine and alcohol consumption, especially near bedtime
  • Setting a consistent bedtime and waking time
  • Avoiding the use of electronics (especially those that emit blue light) a couple of hours prior to bedtime
  • Keeping an optimal sleeping temperature (roughly 65°F) in your bedroom

In case these lifestyle changes are not enough to resolve the issue, your doctor may also prescribe medication (usually a sleeping pill or antidepressant).

Conclusion

Sleep drunkenness is a parasomnia defined by confusion and agitation upon waking up from slow-wave sleep, and it most commonly occurs alongside another sleep disorder or mental disorder.

It has no single cause, though lifestyle changes related to sleep hygiene may reduce the likelihood of having an episode. It’s recommended that you become familiar with good sleep hygiene practices and begin applying them to your routine.

Have you or a loved one ever experienced sleep drunkenness? Feel free to drop us a comment about your experience! And be sure to check out our other guides like the best music to fall asleep to!

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